Article Text

Download PDFPDF

#34723 Lidocaine spray versus other forms for local anesthesia in upper gastrointestinal endoscopy: A systematic review and meta-analysis
  1. Theerada Chandee1,
  2. Sudsayam Manuwong1,
  3. Saritphat Orrapin2,
  4. Neranchala Soonthornkes1,
  5. Prasit Mahawongkajit2,
  6. Chuleerat Suptongchai1 and
  7. Thanatcha Luangmaneerat1
  1. 1Anesthesia, Thammasat University, Pathumthani, Thailand
  2. 2Surgery, Thammasat University, Pathumthani, Thailand


Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)

Application for ESRA Abstract Prizes: I don’t wish to apply for the ESRA Prizes

Background and Aims Pharyngeal anesthesia before esophagogastroduodenoscopy (EGD) reduces pain and discomfort. Many forms of lidocaine are used as local anesthesia. However, it remains unclear which method is the best. We aimed to assess effective each lidocaine’s form during EGD compared with spray.

Methods We searched PubMed, Scopus, EMBASE, the Cochrane Central Register of Controlled Trials, CENTRAL, Web of Science Core Collection, World Health Organization, International Clinical Trials Registry Platform, and databases in December 2022. Selection criteria were randomized controlled trials comparing lidocaine spray with other forms (gel, lozenges, nebulized, popsicle, and viscous) in EGD. Outcomes of interest included ease of instrumentation, participants’ satisfaction scores, tolerance scores, or pain, endoscopist’s satisfaction scores, and procedural time.

Results We included 13 trials with 3,711 participants undergoing EGD. The quality of trials was poor. Lidocaine spray provided better ease of instrumentation (Risk ratio (RR) 1.19, 95% confident intervals (CI)1.06,1.34;I2=66%;very low certainty of evidence), decreased participants’ pain (Mean difference (MD) 0.38, 95% CI 0.25,0.5;I2=92%;very low certainty of evidence), and shorter procedural time (MD 0.22, 95% CI 0.10,0.35;I2=13%;low certainty of evidence). However, spray had lower participants’ highest satisfaction scores (RR 0.83, 95% CI 0.76,0.92;I2=62%;very low certainty of evidence), participants’ mean satisfaction scores (MD -0.61, 95% CI -0.29,-0.04; I2=92%;very low certainty of evidence), participants’ tolerance scores (RR 0.83, 95% CI 0.71,0.97; I2=0%;low certainty of evidence), and endoscopist’s satisfaction scores (MD -0.33, 95% CI -0.45,-0.21;I2=94%;very low certainty of evidence).

Abstract #34723 Figure 1

Preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram

Abstract #34723 Figure 2

Forest plot of ease of instrumentation

Abstract #34723 Figure 3

Risk of bias graph

Conclusions Lidocaine spray may be better for ease of instrumentation during EGD. However, evidence is still determined due to the quality of trials.

  • lidocaine
  • EGD
  • pharyngeal anesthesia

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.